Cholesterol Management (cont.)

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Why is high cholesterol dangerous?

Elevated cholesterol levels are one of the risk factors for heart disease, stroke, and peripheral artery disease. The mechanism involving cholesterol in all three diseases is the same; plaque buildup within arteries decreases blood flow affecting the function of the cells and organs that these blood vessels supply.

Atherosclerotic heart disease or narrowed coronary arteries in the heart can cause the symptoms of angina, when the heart muscle is not provided with enough oxygen to function.

Decreased blood supply to the brain may be due to narrowed small arteries in the brain or because the larger carotid arteries in the neck may become blocked. This can result in a transient ischemic attack (TIA) or stroke.

Peripheral artery disease describes gradual narrowing of the arteries that supply the legs. During exercise, if the legs do not get enough blood supply, they can develop pain, called claudication.

Other arteries in the body may also be affected by plaque buildup causing them to narrow, including the mesenteric arteries to the intestine and the renal arteries to the kidney.

Where does cholesterol come from?

The liver is responsible for managing the levels of LDL in the body. It manufactures and secretes LDL into the bloodstream. There are receptors on liver cells that can “monitor” and try to adjust the LDL levels. However, if there are fewer liver cells or if they do not function effectively, the LDL level may rise.

Diet and genetics both play a factor in a person's cholesterol levels. There may be a genetic predisposition for familial hypercholesterolemia (hyper=more = cholesterol + emia=blood) where the number of liver receptor cells is low and LDL levels rise causing the potential for atherosclerotic heart disease at a younger age.

In the diet, cholesterol comes from saturated fats that are found in meats, eggs, and dairy products. Excess intake can cause LDL levels in the blood to rise. Some vegetable oils made from coconut, palm, and cocoa are also high in saturated fats.